Free-Market Medicine by Michael Parenti

Free-Market Medicine—A Personal Account
by Michael Parenti

When I recently went to Alta Bates hospital for surgery, I discovered that legal procedures take precedence over medical ones. I had to sign intimidating statements about financial counseling, indemnity, patient responsibilities, consent to treatment, use of electronic technologies, and the like.

One of these documents committed me to the following: “The hospital pathologist is hereby authorized to use his/her discretion in disposing of any member, organ, or other tissue removed from my person during the procedure.” Any member? Any organ?

The next day I returned for the actual operation. While playing Frank Sinatra recordings, the surgeon went to work cutting open several layers of my abdomen in order to secure my intestines with a permanent mesh implant. Afterward I spent two hours in the recovery room. “I feel like I’ve been in a knife fight,” I told one nurse. “It’s called surgery,” she explained.

Then, while still pumped up with anesthetics and medications, I was rolled out into the street. The street? Yes, some few hours after surgery they send you home. In countries that have socialized medicine (there I said it), a van might be waiting with trained personnel to help you to your abode.

Not so in free-market America. Your presurgery agreement specifies in boldface that you must have “a responsible adult acquaintance” (as opposed to an irresponsible teenage stranger) take you home in a private vehicle. I kept thinking, what happens to those unfortunates who have no one to bundle them away? Do they languish endlessly in the hospital driveway until the nasty weather finishes them off?

You are not allowed to call a taxi. Were a taxi driver to cause you any harm, you could hold the hospital legally responsible. Again it’s a matter of liability and lawyers, not health and doctors.

One of the two friends who helped me up the steps to my house then went off to Walgreen’s to buy the powerful antibiotics I had to take every four hours for two days. I dislike how antibiotics destroy the “good bacteria” that our bodies produce, and how they help create dangerous strains of super-resistant bacteria. I kept thinking of a recent finding: excessive reliance on medical drugs kills more Americans than all illegal narcotics combined.

So why did I have to take antibiotics? Because, as everyone kept telling me, hospitals are seriously unsafe places overrun with Staph infections and other super bugs. It’s a matter of self-protection.

Two days after surgery I noticed a dark red discoloration on my lower abdomen indicating internal bleeding. I was supposed to get a follow-up call from a nurse who would check on how I was doing. But the call might never come because the staff was planning a walkout. “We have no contract,” one of them had told me when I was in the recovery room. So now the nurses are on strike---and I’m left on my own to divine what my internal bleeding is all about. What fun.

Fortunately, it didn’t turn out that way. A nurse did call me despite the walkout. Yes, she said, it was internal bleeding, but it was to be expected. My surgeon called later in the day to confirm this opinion. Death was not yet knocking.

A few days later, there were massive nurses strikes on both coasts. Among other things, the nurses were complaining about “being disrespected by a corporate hospital culture that demands sacrifices from patients and those who provide their care, but pays executives millions of dollars.” (New York Times, 16 December 2011). One cold-blooded management negotiator was quoted as saying, “We have the money. We just don’t have the will to give it to you” (ibid.).

As for the doctors, both my surgeon and my general practitioner (GP) are among the victims, not the perpetrators, of today’s corporate medical system. My GP explained that it is an endless fight to get insurance companies to pay for services they supposedly cover. Feeling less like a doctor and more like a bill collector, my GP found he could no longer engage in endless telephone struggles with insurance companies.

There are 1,500 medical insurance companies in America, all madly dedicated to maximizing profits by increasing premiums and withholding payments. The medical industry in toto is the nation’s largest and most profitable business, with an annual health bill of about $1 trillion.

Along with the giant insurance and giant pharmaceutical companies, the greatest profiteers are the Health Maintenance Organizations (HMOs), notorious for charging steep monthly payments while underpaying their staffs and requiring their doctors to spend less time with each patient, sometimes even withholding necessary treatment.

I am without private insurance. And my Medicare goes just so far. Like many other doctors, my GP no longer accepts Medicare. For a number of years now, Medicare payments to physicians have remained relatively unchanged while costs of running a practice (staff, office space, insurance) have steadily increased. So now my GP’s patients have to pay in full upon every visit—which is not always easy to do.

Our health system mirrors our class system. At the base of the pyramid are the very poor. Many of them suffer through long hours in emergency rooms only to be turned away with a useless or harmful prescription. No wonder “the United States has the worst record among industrialized nations in treating preventable deaths” (Healthcare-NOW! 1 December 2011).

Too often the very poor get no care at all. They simply die of whatever illness assails them because they cannot afford treatment. An acquaintance of mine told me how her mother died of AIDS because she could not afford the medications that might have kept her alive.

In Houston I once got talking with a limousine driver, a young African-American man, who remarked that both his parents had died of cancer without ever receiving any treatment. “They just died,” he said with a pain in his voice that I can still hear.

Living just above the poor in the class pyramid are the embattled middle class. They watch medical coverage disappear while paying out costly amounts to the profit-driven insurance companies. I was able to get surgery at Alta Bates only because I am old enough to have Medicare and have enough disposable income to meet the co-payment.

For my out-patient operation, the hospital charged Medicare $19,466. Of this, Medicare paid $2,527. And I was billed $644. The hospital then writes off the unpaid balance thus saving considerable sums in taxes (amounting to an indirect subsidy from the rest of us taxpayers). Had I no Medicare coverage, I would have had to pay the entire $19,466.

I was informed by the hospital that the $19,466 charge covers only hospital costs for equipment, technicians, supplies, and room. So besides the $644, I will have to pay for any pathologists, surgical assistants, and anesthesiologists who performed additional services. I am waiting for the other shoe to drop.

How much does my surgeon earn? Not much at all. He gets about $400 to $500 for everything, including my pre-op and post-op visits and the surgery itself, an exacting undertaking that requires skills of the highest sort. He also has to maintain insurance, an office, an assistant, and an increasing load of paperwork.

My surgeon pointed out to me, “If you ask people how much I make on an operation like yours, they will say $4000 to $5000, and be wrong by a factor of ten.” He noted that in a recent speech President Obama criticized a surgeon for charging $30,000 to replace a knee cap. “The surgeon gets a minute fraction of that amount,” my doctor pointed out.

To make matters worse, there is talk about cutting Medicare payments to physicians by 27 percent. If this happens, it is going to be increasingly difficult to find a surgeon who will take Medicare. Still worse, the private insurance companies will join in squeezing the physicians for still more profits.

I was able to meet my payment ($644) not only because my operation was heavily subsidized by Medicare but because it was a one-day “ambulatory surgery.” I don’t know how I would fare if I had to undergo prolonged and extremely costly treatment.

So much for life in the middle class. At the very top of the class pyramid are the 1%, those who don’t have to worry about any of this, the superrich who have money enough for all kinds of state-of-the-art treatments at the very finest therapeutic centers around the world, complete with luxury suites with gourmet menus.

Among the medically privileged are members of Congress and the U.S. president. They pay nothing. They are treated at top-grade facilities. They enjoy, how shall we put it, socialized medicine. No conservative lawmakers have held fast to their free-market principles by refusing to accept this publicly funded, medical treatment.

John Mackey, CEO of Whole Foods, cheerfully announced that medical care is not a human right; it should be “market determined just like food and shelter.” Nobody has a higher opinion of John Mackey than I, and I think he is a greed-driven, union-busting bloodsucker. Nevertheless I will give him credit for candidly admitting his dedication to a dehumanized profit pathology.

The U.S. medical system costs many times more than what is spent in socialized systems, but it delivers much less in the way of quality care and cure. That’s the way it is intended to be. The goal of any free-market service---be it utilities, housing, transportation, education, or health care---is not to maximize performance but to maximize profits often at the expense of performance.

If profits are high, then the system is working just fine---for the 1%. But for us 99%, the profit lust is itself the heart of the problem.

© Michael Parenti, 2011
Michael Parenti’s most recent book is The Face of Imperialism. Go here for further information about him.

Buy his AT release on iTunes!


Michael Parenti on Occupy America!

Occupy America by Michael Parenti
November 8, 2011

Beginning with Occupy Wall Street in September 2011, a protest movement spread across the United States to 70 major cities and hundreds of other communities. Similar actions emerged in scores of other nations.

For the first two weeks, the corporate-owned mainstream media along with NPR did what they usually do with progressive protests: they ignored them. These were the same media that had given the Tea Party supporters saturation coverage for weeks on end, ordaining them “a major political force.”

The most common and effective mode of news repression is omission. By saying nothing or next to nothing about dissenting events, movements, candidates, or incidents, the media consign them to oblivion. When the Occupy movement spread across the country and could no longer be ignored, the media moved to the second manipulative method: trivialization and marginalization.

So we heard that the protestors were unclear about what they were protesting and they were “far removed from the mainstream.” Media cameras focused on the clown who danced on Wall Street in full-blown circus costume, and the youths who pounded bongo drums: “a carnival atmosphere” “yongsters out on a spree,” with “no connection to the millions of middle Americans” who supposedly watched with puzzlement and alarm.

Such coverage, again, was in sharp contrast to the respectful reportage accorded the Tea Party. House Majority Leader, the reactionary Republican Eric Cantor, described the Occupy movement as “growing mobs.” This is the same Cantor who hailed the Tea Party as an unexcelled affirmation of democracy.

The big November 2 demonstration in Oakland that succeeded in closing the port was reported by many media outlets, almost all of whom focused on the violence against property committed by a few small groups. Many of those perpetrators were appearing for the first time at the Oakland site. Some were suspected of being undercover police provocateurs. Their actions seemed timed to overshadow the successful shutdown of the nation’s fourth largest port.

Time and again, the media made the protestors the issue rather than the things they were protesting. The occupiers were falsely described as hippie holdovers and mindless youthful activists. In fact, there was a wide range of ages, socio-ethnic backgrounds, and lifestyles, from homeless to well-paid professionals, along with substantial numbers of labor union members. Far from being a jumble of confused loudmouths prone to violence, they held general assemblies, organized themselves into committees, and systematically took care of encampment questions, food, security, and sanitation.

One unnoticed community protest was Occupy Walnut Creek. For those who don’t know, Walnut Creek is a comfortable conservative suburb in northern California (with no known record of revolutionary insurrections). Only one local TV station gave Occupy Walnut Creek brief attention, noting that about 400 people were participating, average age between 40 and 50, no clowns, no bongos. Participants admitted that they lived fairly prosperous lives but still felt a kinship with the millions of Americans who were enduring an economic battering. Here was a contingent of affluent but rebellious “middle Americans” yet Walnut Creek never got mentioned in the national media, as far as I know.

The Occupy movement has promulgated a variety of messages. With a daring plunge into class realities, the occupiers talk of the 1% who are exploiting the 99%, a brilliant propaganda formula, simple to use, yet saying so much, now widely embraced even by some media commentators. The protestors carried signs condemning the republic’s terrible underemployment and the empire’s endless wars, the environmental abuses perpetrated by giant corporations, the tax loopholes enjoyed by oil companies, the growing inequality of incomes, and the banksters and other gangsters who feed so lavishly from the public trough.

Some occupiers even denounced capitalism as a system and hailed socialism as a humane alternative. In all, the Occupy movement revealed an awareness of systemic politico-economic injustices not usually seen in U.S. protests. Remember, the initial and prime target was Wall Street, finance capital’s home base.

The mainstream news outlets not only control opinions but even more so opinion visibility, which in turn allows them to limit the parameters of public discourse. This makes it all the more imperative for ordinary people to join together in demonstrations, hoping thereby to maximize the visibility and impact of their opinions. The goal is to break through the near monopoly of conservative orthodoxy maintained by the “liberal” media.

So demonstrations are important. They have an energizing effect on would-be protestors, bringing together many who previously had thought themselves alone and voiceless. Demonstrations bring democracy into the streets. They highlight issues that have too long been buried. They mobilize numbers, giving a show of strength, reminding the plutocracy perched at the apex that the pyramid is rumbling.

But demonstrations should evolve into other forms of action. This has already been happening with the Occupy movement. It is more than a demonstration because its protestors did not go home at the end of the day. In substantial numbers they remained downtown, putting their bodies on the line, imposing a discomfort on officialdom just by their numbers and presence.

At a number of Occupy sites there have been civil disobedience actions, followed by arrests. In various cities the police have been unleashed with violent results that sometimes have backfired. In Oakland ex-Marine Scott Olsen was hit by a police teargas canister that busted his skull and left him hospitalized and unable to speak for a week. At best, he faces a long slow recovery. The day after Olsen was hit, hundreds of indignant new protestors joined the Occupy Oakland site. Police brutality incites a public reaction, often bringing more people out, just the opposite of what officials want.

Where does this movement go? What is to be done? The answers are already arising from the actions of the 99%:

--Discourage military recruitment and support conscientious objectors. Starve the empire of its legions. Organize massive tax resistance in protest of corrupt, wasteful, unlawful, and destructive Pentagon spending.

--Transfer funds from corporate banks to credit unions and community banks. Support programs that assist the unemployed and the dispossessed. It was Giulio Tremonti, Italy’s embattled finance minister who declared: “Salvate il popolo, non le banche” (“Save the people, not the banks”). It would be nice to hear such sentiments emanating from the U.S. Treasury Department or the White House.

--Coordinate actions with organized labor. Unions still are the 99%’s largest and best financed groups. Consider what was done in Oakland: occupiers joined with longshoremen, truckers, and other workers to close the port. Already there are plans for a general strike in various communities. Such actions improve greatly if organized labor is playing a role.

--We need new electoral strategies, a viable third party, proportional representation, and even a new Constitution, one that establishes firm rules for an egalitarian democracy and is not a rigmarole designed to protect the moneyed class. The call for a constitutional convention (a perfectly legitimate procedure under the present U.S. Constitution) seems long overdo.

--Perhaps most of all, we need ideological education regarding the relationship between wealth and power, the nature of capitalism, and the crimes of an unbridled profit-driven financial system. And again the occupiers seem to be moving in that direction: in early November 2011, people nationwide began gathering to join teach-ins on “How the 1% Crashed the Economy.”

We need to explicitly invite the African-American, Latino, and Asian communities into the fight, reminding everyone that the Great Recession victimizes everyone but comes down especially hard on the ethnic poor.

We need to educate ourselves regarding the beneficial realities of publicly owned nonprofit utilities, publicly directed environmental protections, public nonprofit medical services and hospitals, public libraries, schools, colleges, housing, and transportation--all those things that work so well in better known in some quarters as socialism.

There is much to do. Still it is rather impressive how the battle is already being waged on so many fronts. Meanwhile the corporate media ignore the content of our protest while continuing to fulminate about the occupiers’ violent ways and lack of a precise agenda.

Do not for one moment think that the top policymakers and plutocrats don’t care what you think. That is the only thing about you that wins their concern. They don’t care about the quality of the air you breathe or the water you drink, or how happy or unhappy or stressed and unhealthy or poor you might be. But they do want to know your thoughts about public affairs, if only to get a handle on your mind. Every day they launch waves of disinformation to bloat your brains, from the Pentagon to Fox News without stint.

When the people liberate their own minds and take a hard clear look at what the 1% is doing and what the 99% should be doing, then serious stuff begins to happen. It is already happening. It may eventually fade away or it may create a new chapter in our history. Even if it does not achieve its major goals, the Occupy movement has already registered upon our rulers the anger and unhappiness of a populace betrayed.

Michael Parenti’s most recent book is The Face of Imperialism. Go here for further information about him.

Buy his AT release on iTunes!



Alternative Tentacles will be closed on Wednesday, November 2nd to show solidarity with the General Strike recently proposed by the Occupy Oakland movement!

[DOA's "General Strike" set to 2011 Wisconsin protest footage!]

The occupiers' proposal follows:

"We as fellow occupiers of Oscar Grant Plaza propose that on Wednesday November 2, 2011, we liberate Oakland and shut down the 1%.

"We propose a city wide general strike and we propose we invite all students to walk out of school. Instead of workers going to work and students going to school, the people will converge on downtown Oakland to shut down the city.

"All banks and corporations should close down for the day or we will march on them.

"While we are calling for a general strike, we are also calling for much more. People who organize out of their neighborhoods, schools, community organizations, affinity groups, workplaces and families are encouraged to self organize in a way that allows them to participate in shutting down the city in whatever manner they are comfortable with and capable of.

"The whole world is watching Oakland. Let's show them what is possible."
General Strike

One of the most well known U.$. general strikes occurred over a five day period in Seattle, 1919, with 60,000 union members and 40,000 non-union sympathizers walking out and taking to the streets. The city all but stopped functioning, with exceptions made for essential services (firefighters, hospital staff, and the like). Crime plummeted, neighborhood kitchens were set up to feed the populace, and a staunch anti-authoritarian spirit permeated the city.

That peaceful strike ended with National Guard interference and the subsequent anarchist / socialist / IWW witch hunt that followed. Let's hope this one ends on a better note!

(info taken from chapter 15 of Howard Zinn's classic "A People's History Of The U.S.", available in its entirety online): http://www.historyisaweapon.com/zinnapeopleshistory.html

For up-to-date Oakland Occupation information:

We Are The 99%!


Jello shoots awful flooding in Vermont

Here is footage shot by Jello on his phone of some of the horrible flooding in Vermont last month due to Hurricane Irene.


Back to the Old School Sale!

Back to school- that is, the OLD SCHOOL!

16 of our favorite 1980s punk records on AT are on sale for $4.99 each only on iTunes for the month of SEPTEMBER 2011. Here's a sampling!

1980s Hardcore Punk Sale by AlternativeTentacles


Nardwuar vs. Jello Biafra, with Ani Kyd and more!

Straight outta Vancouver from the set of "I Love You, I Am the Porn Queen," written and directed by Ani Kyd of Fuel Injected .45!